Damaged tendon can cause flatfoot

Putting your best foot forward may not be so easy if pain is involved.

Posterior tibial tendon dysfunction (PTTD) is a common foot and ankle problem. It occurs when the posterior tibial tendon is injured, torn, overused, or swollen, inhibiting its ability to support the arch. Damage can occur from common activities, such as running, walking, hiking, or climbing stairs.

Symptoms of PTTD include pain along the inside of the foot and ankle, which worsens with activity. As the arch begins to flatten, the foot and toes begin to turn outward and the ankle rolls inward.

The posterior tibial tendon is a major supporting structure of the foot. It attaches the calf muscle to the bones on the inside of the foot. The tendon’s main function is to hold up the arch and support the foot when walking.

According to the American College of Foot and Ankle Surgeons, flatfoot typically occurs in only one foot, though some people may develop it in both feet. PTTD is usually progressive, which means it will keep getting worse, especially if it is not treated early.

PTTD is often called adult acquired flatfoot, a condition in which the arch of the foot falls or collapses. It is different than flatfoot in children. Children usually outgrow flatfoot on their own, often without treatment.

According to the American Academy of Orthopaedic Surgeons, PTTD is more common in women and adults age 40 and older. Additional risk factors include obesity, diabetes, hypertension, and rheumatoid arthritis.

Because of the progressive nature of PTTD, early treatment is recommended. Nonsurgical treatments include the following:

• Orthotic devices or bracing
• Immobilization (short-leg cast or boot)
• Physical therapy
• Medications
• Shoe modifications

In some instances, surgery may be necessary. Surgery is performed by orthopedic and podiatric surgeons.

Prevention is the best medicine

The American Academy of Orthopaedic Surgeons offers the following tips to prevent ankle sprains:

• Warm up thoroughly before exercise and physical activity.
• Pay careful attention when walking, running, or working on an uneven surface.
• Wear shoes that are made for your activity.
• Slow down or stop activities when you feel pain or fatigue.